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Brosolo G, Da Porto A, Bulfone L, Vacca A, Bertin N, Vivarelli C, Catena C, Sechi LA. Daytime plasma cortisol and cortisol response to dexamethasone suppression are associated with a prothrombotic state in hypertension. Front Endocrinol (Lausanne) 2024; 15:1397062. [PMID: 38836224 PMCID: PMC11148267 DOI: 10.3389/fendo.2024.1397062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/30/2024] [Indexed: 06/06/2024] Open
Abstract
Background and aims A prothrombotic state was demonstrated in patients with Cushing's syndrome and is involved in the development and progression of cardiovascular and renal damage in hypertensive patients. This study was designed to examine the relationships between cortisol secretion and the hemostatic and fibrinolytic systems in hypertension. Methods In 149 middle-aged, nondiabetic, essential hypertensive patients free of cardiovascular and renal complications, we measured hemostatic markers that express the spontaneous activation of the coagulation and fibrinolytic systems and assessed daily cortisol levels (8 AM, 3 PM, 12 AM; area under the curve, AUC-cortisol) together with the cortisol response to dexamethasone overnight suppression (DST-cortisol). Results Plasma levels of D-dimer (D-dim), prothrombin fragment 1 + 2 (F1 + 2), and von Willebrand factor (vWF) were progressively and significantly higher across tertiles of AUC-cortisol and DST-cortisol, whereas no differences were observed in fibrinogen, tissue plasminogen activator, plasminogen activator inhibitor-1, antithrombin III, protein C, and protein S. D-dim, F1 + 2, and vWF were significantly and directly correlated with age and both AUC-cortisol and DST-cortisol. Multivariate regression analysis showed that both AUC-cortisol and DST-cortisol were related to plasma D-dim, F1 + 2, and vWF independently of age, body mass index, blood pressure, and renal function. Conclusion Greater daily cortisol profile and cortisol response to overnight suppression are independently associated with a prothrombotic state in hypertensive patients and might contribute to the development of organ damage and higher risk of cardiovascular complications.
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Affiliation(s)
- Gabriele Brosolo
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Andrea Da Porto
- Diabetes and Metabolism Unit, Department of Medicine, University of Udine, Udine, Italy
| | - Luca Bulfone
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Antonio Vacca
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Nicole Bertin
- Thrombosis and Hemostasis Unit, Department of Medicine, University of Udine, Udine, Italy
| | - Cinzia Vivarelli
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Cristiana Catena
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Leonardo A Sechi
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
- Diabetes and Metabolism Unit, Department of Medicine, University of Udine, Udine, Italy
- Thrombosis and Hemostasis Unit, Department of Medicine, University of Udine, Udine, Italy
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Brosolo G, Da Porto A, Bulfone L, Vacca A, Bertin N, Vivarelli C, Sechi LA, Catena C. Association of arterial stiffness with a prothrombotic state in uncomplicated nondiabetic hypertensive patients. Front Cardiovasc Med 2023; 10:1119516. [PMID: 36895833 PMCID: PMC9988910 DOI: 10.3389/fcvm.2023.1119516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
Background and aims Past studies reported a significant contribution of a prothrombotic state to the development and progression of target organ damage in hypertensive patients. Stiffening of arterial vessels is associated with aging and hypertension, and additional factors could contribute to this process. This study was designed to examine the relationships between arterial stiffening and the hemostatic and fibrinolytic system. Methods In 128 middle-aged, nondiabetic, essential hypertensive patients without major cardiovascular and renal complications, we measured coagulation markers that express the spontaneous activation of the hemostatic and fibrinolytic system and assessed stiffness of the arterial tree by measurement of the carotid/femoral pulse wave velocity (cfPWV) and pulse wave analysis with calculation of the brachial augmentation index (AIx). Results Levels of fibrinogen (FBG), D-dimer (D-d), and plasminogen activator-inhibitor 1 (PAI-1) were significantly higher in patients with PWV and AIx above the median of the distribution. FBG, D-d, and PAI-1 were significantly and directly related with both cfPWV and AIx, and multivariate regression analysis indicated that the relationships of D-d and PAI-1 with both cfPWV and AIx and of FBG with AIx, were independent of age, body mass index, severity and duration of hypertension, use of antihypertensive drugs, blood glucose, and plasma lipids. Conclusion In middle-aged, uncomplicated, nondiabetic patients with essential hypertension, spontaneous activation of plasma hemostatic cascade and impaired fibrinolysis is significantly and independently associated with stiffening of the arterial tree.
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Affiliation(s)
- Gabriele Brosolo
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Andrea Da Porto
- Diabetes and Metabolism Unit, Department of Medicine, University of Udine, Udine, Italy
| | - Luca Bulfone
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Antonio Vacca
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Nicole Bertin
- Thrombosis and Hemostasis Unit, Department of Medicine, University of Udine, Udine, Italy
| | - Cinzia Vivarelli
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy
| | - Leonardo A Sechi
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy.,Diabetes and Metabolism Unit, Department of Medicine, University of Udine, Udine, Italy.,Thrombosis and Hemostasis Unit, Department of Medicine, University of Udine, Udine, Italy
| | - Cristiana Catena
- Internal Medicine and European Hypertension Excellence Center, Department of Medicine, University of Udine, Udine, Italy.,Diabetes and Metabolism Unit, Department of Medicine, University of Udine, Udine, Italy.,Thrombosis and Hemostasis Unit, Department of Medicine, University of Udine, Udine, Italy
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Para I, Albu A, Porojan MD. Adipokines and Arterial Stiffness in Obesity. ACTA ACUST UNITED AC 2021; 57:medicina57070653. [PMID: 34202323 PMCID: PMC8305474 DOI: 10.3390/medicina57070653] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 12/11/2022]
Abstract
Adipokines are active molecules with pleiotropic effects produced by adipose tissue and involved in obesity-related metabolic and cardiovascular diseases. Arterial stiffness, which is a consequence of arteriosclerosis, has been shown to be an independent predictor of cardiovascular morbidity and mortality. The pathogenesis of arterial stiffness is complex but incompletely understood. Adipokines dysregulation may induce, by various mechanisms, vascular inflammation, endothelial dysfunction, and vascular remodeling, leading to increased arterial stiffness. This article summarizes literature data regarding adipokine-related pathogenetic mechanisms involved in the development of arterial stiffness, particularly in obesity, as well as the results of clinical and epidemiological studies which investigated the relationship between adipokines and arterial stiffness.
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Affiliation(s)
- Ioana Para
- 4th Department of Internal Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania;
| | - Adriana Albu
- 2nd Department of Internal Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania;
- Correspondence:
| | - Mihai D. Porojan
- 2nd Department of Internal Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania;
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Liu R, Yang L, Wei Q. miR-34a targets PAI-1 to regulate urinary microalbumin and renal function in hypertensive mice. Eur J Med Res 2020; 25:3. [PMID: 32178735 PMCID: PMC7077132 DOI: 10.1186/s40001-020-00404-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/17/2020] [Indexed: 12/11/2022] Open
Abstract
Background The aim of the study is to investigate the effects of miR-34a targeted at PAI-1 on urinary microalbumin and renal function in hypertensive mice. Methods Twenty specific-pathogen-free (SPF) BPN/3J mice were selected in normal group, and 120 SPF BPH/2J mice were evenly divided into model group, negative control group, miR-34a mimic group, miR-34a inhibitor group, Si-PAI-1 group, and miR-34a inhibitor + Si-PAI-1 group. qRT-PCR was used to detect the expression of miR-34a and PAI-1 mRNA. The protein expressions of PAI-1, angiotensin-converting enzyme (ACE) and ACE2 were detected by Western blot. Serum levels of AngII and Ang1-7 were detected by ELISA. Results miR-34a negatively regulated the expression of PAI-1. Compared with the normal group, mice in the other groups had significantly lower body weight, increased systolic blood pressure and 24-h urinary microalbumin content, decreased miR-34a expression, superoxide dismutase (SOD) and nitric oxide (NO) content, and ACE2 protein expression, and increased PAI-1 expression, serum creatinine (Scr), blood urea nitrogen (BUN) malondialdehyde (MDA), AngII and Ang1-7 levels, and ACE protein expression (all P < 0.05). Compared with the model group, mice in the miR-34a mimic group and Si-PAI-1 group had no significant changes in body weight (all P > 0.05), while they had significantly lower systolic blood pressure and 24-h urinary microalbumin content, increased SOD and NO levels and ACE2 protein expression, and decreased PAI-1 expression, Scr, BUN, MDA, AngII and Ang1-7 levels, and ACE protein expression (all P < 0.05). Compared with the miR-34a inhibitor group, symptoms in miR-34a inhibitor + Si-PAI-1 group were significantly improved (all P < 0.05). Conclusions miR-34a can inhibit the expression of PAI-1, thereby reducing urinary microalbumin content in hypertensive mice and protecting their renal function.
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Affiliation(s)
- Ruitao Liu
- Department of Cardiovascular Medicine, Xingtai People's Hospital, No.16 Hongxing East Street, Qiaodong District, Xingtai, 054000, Hebei, China
| | - Lihong Yang
- Department of Cardiovascular Medicine, Xingtai People's Hospital, No.16 Hongxing East Street, Qiaodong District, Xingtai, 054000, Hebei, China
| | - Qingmin Wei
- Department of Cardiovascular Medicine, Xingtai People's Hospital, No.16 Hongxing East Street, Qiaodong District, Xingtai, 054000, Hebei, China.
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